Most Relevant Information
Provider Data
| NPI Number: | 1003395658 |
| Provider Name: | KRISTEN OTA PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 1835P0018X |
| Specialty: | Pharmacist |
| License Number: | S023336 |
Most Important Dates
| Enumeration Date: | 08/13/2018 |
| Last Updated: | 11/14/2022 |
Provider Practice Location
4620 E BASELINE RD
MESA
AZ
852064624
Practice Location Phone/Fax
| Phone: | 4808324770 |
| Fax: |
Provider Mailing Location
4620 E BASELINE RD
MESA
AZ
852064624
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |